Objective To observe the effect of etomidate fat emulsion used for elderly patients with intravenous anesthesia induction and maintenance, and discuss its safety.Methods Total of 72 elderly patients needing general anesthesia in Shangluo City Central Hospital from Sep .2013 to Sep.2014 were included as research objects,and they were divided into propofol group and etomidate group with 36 cases in each group according to random number table method.Induction of anesthesia:both groups were given 0.03 mg/kg midazolam, 3 μg/kg fentanyl,0.15 mg/kg cis-atracurium,and the propofol group was given 1-2 mg/kg propofol,etomidate group was given 0.15-0.30 mg/kg etomidate;anesthesia maintenance:propofol group was given 6 -8 mg/(kg・ h) propofol treatment,and etomidate group was given 0.3-1.0 mg/(kg・ h) etomidate treatment.The effect of anesthesia was compared between the two groups, and the vital signs of life signs, aldosterone,and plasma cortisol levels of the two groups were recorded.Results Mean arterial pressure, heart rate and oxygen saturation of etomidate group at different time points had no obvious fluctuation;mean arterial pressure and heart rate at T2,T3,T4 in propofol group were significantly lower than that at T1 and T5;aldosterone, cortisol levels at T2 ,T3 ,T6 moment in etomidate group were lower than those at T1 and T7 ,and adrenal cortex hormone levels at T1,T2 and T7 were lower than T3 and T6; aldosterone levels in propofol group at different time points had no obvious fluctuation,adrenal cortex hormone levels at T3 ,T6 were lower than T1,T2 and T7,cortisol levels at T1,T7 were lower than T3.2 cases(6.0%) of myoclonus happened during induction in etomidate group,3 cases (8.0%) of injection pain happened in propofol group,the adverse reactions incidence of the two groups had no significant difference(P >0.05).Conclusion The effect of etomidate fat emulsion for total intravenous anesthesia of the elderly patients is better ,and the hemo-dynamics is more stable,with good safety.%目的：观察依托咪酯脂肪乳用于老年患者全凭静脉麻醉诱导及维持效果，并探讨其安全性。方法选择2013年9月至2014年9月商洛市中心医院收治的行全身麻醉老年患者72例为研究对象，按照随机数字表法分为丙泊酚组和依托咪酯组，各36例。麻醉诱导：两组均给予咪达唑仑0.03 mg／kg、芬太尼3μg／kg、顺－阿曲库铵0.15 mg／kg，丙泊酚组给予丙泊酚1～2 mg／kg，依托咪酯组给予依托咪酯0.15～0.30 mg／kg；麻醉维持：丙泊酚组给予6～8 mg／（ kg・ h），依托咪酯组给予依托咪酯0.3～1.0 mg／（ kg・ h）。比较两组患者麻醉效果，并记录诱导前1 min（ T1）、插管后即刻（ T2）、切皮时（ T3）、手术开始30 min（ T4）、拔管即刻（ T5）不同时点间两组患者生命体征相关指标及T1、T2、T3、手术开始2 h（T6）、术后24 h（T7）的醛固酮、促肾上腺皮质激素、血浆皮质醇水平。结果依托咪酯组患者不同时点间的平均动脉压、心率和血氧饱和度无明显波动；丙泊酚组患者在 T2、T3、T4平均动脉压和心率均明显低于T1和T5；依托咪酯组 T2、T3、T6醛固酮、皮质醇水平均低于 T1和 T7， T1、T2、T7促肾上腺皮质激素水平均低于 T3和 T6；丙泊酚组患者不同时点间醛固酮水平无明显波动，T3、T6时刻促肾上腺皮质激素水平均低于 T1、T2和 T7，T1、T7时刻皮质醇水平均低于 T3。依托咪酯组诱导过程中出现2例（6.0％）肌阵挛，丙泊酚组出现3例（8.0％）注射痛，两组不良反应发生率比较差异无统计学意义（ P＞0.05）。结论依托咪酯脂肪乳用于老年患者全凭静脉麻醉效果较佳，且血流动力学较为稳定，应用安全。
展开▼
